Alcohol: A deadly addiction

Published 8:00 pm, Saturday, September 18, 2010

NEW CANAAN

By JERROD FERRARI

Hour Staff Writer

Recovering from alcohol addiction can be deadly.

In most cases, alcoholics will relapse. In serious cases as high as 80 to 90 percent will.

Dr. Sigurd Ackerman, president and medical director of Silver Hill Hospital in New Canaan and a professor of Clinical Psychiatry, Columbia University College of Physicians & Surgeons, said that alcoholism cannot be predicted, but there is always a path to recovery if the patient "wants to be a patient."

Three things generally trigger someone into rehab, according to Ackerman: The legal system, one's family or one's job.

According to Ackerman, being forced into facing your problems from work can be the most difficult.

"With the other ways, you can kind of see it coming," he said. "With families, usually there is some sort of conversation that is had before coming in (to rehab). With work, it is usually that they have been watching you for a while and then just tell you one day that you need help."

According to recent studies, it has been discovered that approximately 53 percent of adults in the United States have reported that one or more of their close relatives has a drinking problem.

An estimated two-thirds of all patients that enter Silver Hill have co-occurring disorders. This means that while battling alcoholism, the patient is also dealing with a psychiatric problem or another addiction.

"Alcoholism itself can create a second disorder," said Ackerman, who has been with Silver Hill for the past seven years.

Once a patient is admitted to the hospital, the first step is to evaluate the patient and identify the problem. Once the problem or problems are determined, only then can the patient continue on to detox.

During alcohol detox, the most important thing is to get the patient off alcohol. When that occurs, there is a withdrawal and symptoms can be from mild to life threatening.

According to Ackerman, severe withdrawals or delirium tremens known as DTs can be life threatening. DTs include profound confusion, hallucinations, hyperactivity, disorientation and extreme cardiovascular disturbances, which include changes in breathing, circulation and body temperature, racing heart, high blood pressure and dehydration. DTs can heart attacks and strokes, creating fatalities.

"Heroin (withdrawal) can not be fatal," said Ackerman, explaining that withdrawing from alcohol is more dangerous then doing so from one of the world's most addictive drugs.

"Heroin is more symptomatic," he said, adding however that heroin withdrawal can be much more painful.

After detox, Ackerman said that patients have no feeling of euphoria but "feel better."

Silver Hill Hospital, an academic affiliate of Yale University School of Medicine Department of Psychiatry, treats 2,400 patients a year and approximately 15 percent are there for alcohol abuse.

Notable people who have been rumored to have been treated at Silver Hill Hospital -- not all for alcohol abuse -- include Edie Sedgwick, Gregg Allman, Truman Capote, Mariah Carey, Michael Jackson, Billy Joel, Joan Kennedy, Liza Minnelli, and Nick Nolte.

Once a patient is fully detoxed -- which can take from four to six days in a hospital setting -- the preferred next step is to enter a rehabilitation situation but not all patients do.

"Some just say they are done, go home and never drink again," said Ackerman, acknowledging that is not the norm.

Some patients seek help from groups like Alcoholics Anonymous and more intensive outpatients will do therapy three hours a day for three days a week.

The World Health Organization estimates that about 76 million people throughout the world suffer from alcohol-related disorders.

"It is the craving after you are off that drug that is to worry about," said Ackerman. "Rehab is all about not relapsing."

Ackerman said that when someone is addicted to any substance the brain changes chemically, and it stays that way.

In rehab -- particularly at Silver Hill Hospital -- it is the mutual support the patients give each other in the rehab portion of the problem that often makes the difference.

"It is the surroundings and support that make it work," said Ackerman. "They are together all day and all evening, day in and day out. They eat together, play Frisbee together and go to class together."

In rehab, patients are educated about the science behind addiction so that they might understand what is happening to them on that level.

"In order to stop drinking, you have to make up your mind to stop drinking," said Ackerman. "If they don't do that, nothing helps."

A patient, according to Ackerman, does not need to make up their mind before treatment.

"Often they do this once they enter treatment," he said.

At Silver Hill, the family is included in a patient's recovery. Often having to deal with patients' "triggers" and relapses after release ,the hospital believes that a family "must" be included in recovery.

Early in sobriety, anything from a specific work situation to a TV commercials can be a threat to cause a relapse. These types of situations are called triggers. Simply, a trigger is something that prompts one to think about, crave, and ultimately relapse on alcohol.

Triggers vary depending on the alcoholic and his or her history and patterns of use. For example, some alcoholics cannot go to bars after they get sober (at least for a long time), because it makes them think about the romantic aspects of their use. Others are fine in bars, because they always drank alone in their apartments.

Silver Hill Hospital will soon begin a new aspect to their treatment and new to the industry as a whole. They will work with outside therapists and groups to follow a released patient for up to a year.